What would be the best long-term treatment for my hollow under eyes? (Photos)

Hello and thank you for your question. A formal evaluation would be needed to determine the best treatment. There are both surgical and non-surgical options to correct this, depending on your specific situation.

For less significant puffiness and sagging UNDER the eyes, or more mild improvement, there are nonsurgical treatment options: we often use Renuvion helium plasma radiofrequency (RF) energy to achieve incredible results and take years off of your appearance. Combining RF energy and cool helium plasma, the signs of aging (wrinkles, pigmentation, skin laxity) are improved in a ‘Nonsurgical Lower Eyelid Lift.' The focused heating tightens and peels the outer skin layer with extreme precision, leaving the surrounding area undamaged, smoothing and tightening the periorbital skin, and improving the overall skin quality around the eyes. It's an aggressive treatment, and the recovery time is longer than with other nonsurgical procedures, but the results can be life-changing.​

Surgery (a lower blepharoplasty with or without canthopexy/canthoplasty or orbicularis muscle suspension) is a great option for more significant improvement- for example if there are more severe lower eyelid bags / bulging present. Sometimes the surgery can also be used to intentionally adjust the shape and/or size of your eyes, or correct any asymmetries!

Dr. Donald Groves is an expert facial plastic surgeon that I work with, who specializes in these types of procedures. It is important that if you are considering surgery that you go to someone who is well trained and very experienced with these delicate operations to get the best results. I suggest getting a consultation with an experienced cosmetic dermatologist and facial sculpting expert, or an aesthetic facial plastic surgeon like Dr. Groves; we are both located right here in Los Angeles.

Best,
Dr. Emer

You would benefit from a lower blepharoplasty. This will release the orbital fat to eliminate the horizontal wrinkles.

Best Wishes,

Gary Horndeski, M.D.

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin in Winnetka and Chicago. This is a great question. Based on your concerns, I recommend treatments with Botox and dermal filler. Botox injections can help reduce the appearance of undereye jelly rolls, which are caused by muscle contraction and skin laxity. By targeting the orbicularis oculi muscle with Botox, the movement that contributes to the jelly roll can be minimized, leading to smoother skin and a more rested appearance. Dermal fillers, such as hyaluronic acid-based products, are used to treat undereye hollows or tear troughs. These hollows can create a shadowed appearance and make the eyes look tired. By carefully injecting filler into the tear trough area, volume is restored, effectively reducing the hollows and creating a smoother transition between the lower eyelid and cheek. Combining these treatments can provide comprehensive rejuvenation for the undereye area, addressing both dynamic wrinkles and volume loss. I hope this helps and best of luck!